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General NPI Number Information
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NPI Number | 1730555103
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Entity Type | Individual
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Provider Name | ANGELA NELSON
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Gender | Female
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 3281 N MAIN ST
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City | SPANISH FORK
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State | UT
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Zip | 84660-8501
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Country | US
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Telephone | 801-851-7652
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Fax |
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Provider Business Mailing Address
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Address Line | 2136 N 40 W APT 357
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City | PROVO
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State | UT
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Zip | 84604-7657
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Country | US
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Telephone | 407-967-0236
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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